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Current Infectious Disease Reports

Erschienen in:

01.09.2016 | Pediatric Infectious Diseases (I Brook, Section Editor)

Cryptococcal Disease in HIV-Infected Children

verfasst von: Carol Kao, David L. Goldman

Erschienen in: Current Infectious Disease Reports | Ausgabe 9/2016

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Abstract

Cryptococcus neoformans is an encapsulated fungal pathogen that is remarkable for its tendency to cause meningoencephalitis, especially in patients with AIDS. While disease is less common in children than adults, it remains an important cause of morbidity and mortality among HIV-infected children without access to anti-retroviral therapy. This review highlights recent insights into both the biology and treatment of cryptococcosis with a special emphasis on the pediatric literature.

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Fonseca FL, Guimaraes AJ, Kmetzsch L, Dutra FF, Silva FD, Taborda CP, et al. Binding of the wheat germ lectin to Cryptococcus neoformans chitooligomers affects multiple mechanisms required for fungal pathogenesis. Fungal Genet Biol. 2013;60:64–73. This study implicates chitin as a virulence factor in CME.CrossRefPubMedPubMedCentral

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Bouklas T, Pechuan X, Goldman DL, Edelman B, Bergman A, Fries BC. Old Cryptococcus neoformans cells contribute to virulence in chronic cryptococcosis. mBio. 2013; 4(4). Initial description of ageing in C. neoformans and its potential contribution to CME pathogenesis.

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Albuquerque P, Nicola AM, Nieves E, Paes HC, Williamson PR, Silva-Pereira I, et al. Quorum sensing-mediated, cell density-dependent regulation of growth and virulence in Cryptococcus neoformans. mBio. 2014;5(1):e00986–00913. Describes pantothenic acid-mediated quorum sensing in C. neformans and its potential role in disease.CrossRef

30.

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33.

Goldman DL, Lee SC, Mednick AJ, Montella L, Casadevall A. Persistent Cryptococcus neoformans pulmonary infection in the rat is associated with intracellular parasitism, decreased inducible nitric oxide synthase expression, and altered antibody responsiveness to cryptococcal polysaccharide. Infect Immun. 2000;68(2):832–8.CrossRefPubMedPubMedCentral

34.

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37.••

Vu K, Tham R, Uhrig JP, Thompson 3rd GR, Na Pombejra S, Jamklang M, et al. Invasion of the central nervous system by Cryptococcus neoformans requires a secreted fungal metalloprotease. mBio. 2014;5(3):e01101–14. Reports the discovey of a metalloprotease involved in the translocation of C. neoformans into the CNS.CrossRefPubMedPubMedCentral

38.

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Jong A, Wu CH, Shackleford GM, Kwon-Chung KJ, Chang YC, Chen HM, et al. Involvement of human CD44 during Cryptococcus neoformans infection of brain microvascular endothelial cells. Cell Microbiol. 2008;10(6):1313–26.CrossRefPubMed

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44.

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Rohatgi S, Gohil S, Kuniholm MH, Schultz H, Dufaud C, Armour KL, et al. Fc gamma receptor 3A polymorphism and risk for HIV-associated cryptococcal disease. mBio. 2013;4(5):e00573–00513. Study that implicates Fc polymorphisms as a contributing risk factor for CME in HIV-infected patients.CrossRefPubMedPubMedCentral

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Hashimoto H, Hatakeyama S, Yotsuyanagi H. Development of cryptococcal immune reconstitution inflammatory syndrome 41 months after the initiation of antiretroviral therapy in an AIDS patient. AIDS Res Ther. 2015;12:33. A report describing a delayed presentatiion of IRIS-associated CME. CrossRefPubMedPubMedCentral

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Bisson GP, Molefi M, Bellamy S, Thakur R, Steenhoff A, Tamuhla N, et al. Early versus delayed antiretroviral therapy and cerebrospinal fluid fungal clearance in adults with HIV and cryptococcal meningitis. Clin Infect Dis. 2013;56(8):1165–73. Study that suggest that early ART does not result in early CSF clearance but may increase the risk of IRIS. CrossRefPubMed

99.••

Boulware DR, Meya DB, Muzoora C, Rolfes MA, Huppler Hullsiek K, Musubire A, et al. Timing of antiretroviral therapy after diagnosis of cryptococcal meningitis. N Engl J Med. 2014;370(26):2487–98. A recent report that describes significant increase in mortality associated with early ART in CME, espcially for those with low initial CSF white blood cell counts. CrossRefPubMedPubMedCentral

100.•

Scriven JE, Rhein J, Hullsiek KH, von Hohenberg M, Linder G, Rolfes MA, et al. Early ART after cryptococcal meningitis is associated with cerebrospinal fluid pleocytosis and macrophage activation in a multisite randomized trial. J Infect Dis. 2015;212(5):769–78. A characterization of the cellular response of the CSF in patients with CME that finds evidence for inappropriate macrophage activation in pateints with IRIS. CrossRefPubMedPubMedCentral

101.•

Chang CC, Lim A, Omarjee S, Levitz SM, Gosnell BI, Spelman T, et al. Cryptococcosis-IRIS is associated with lower cryptococcus-specific IFN-gamma responses before antiretroviral therapy but not higher T-cell responses during therapy. J Infect Dis. 2013;208(6):898–906. A study that reports low cryptococal specfic T-cells prior to ART therapy as a risk factor for the development of IRIS. CrossRefPubMedPubMedCentral

Titel: Cryptococcal Disease in HIV-Infected Children
verfasst von: Carol Kao
David L. Goldman
Publikationsdatum: 01.09.2016
Verlag: Springer US
Erschienen in: Current Infectious Disease Reports / Ausgabe 9/2016
Print ISSN: 1523-3847
Elektronische ISSN: 1534-3146
DOI: https://doi.org/10.1007/s11908-016-0534-9

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Cryptococcal Disease in HIV-Infected Children

Abstract

Leitlinien kompakt für die Innere Medizin

Neu im Fachgebiet Innere Medizin

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

Adjuvante Immuntherapie verlängert Leben bei RCC

Alectinib verbessert krankheitsfreies Überleben bei ALK-positivem NSCLC

Update Innere Medizin

Springer Medizin

Abstract

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Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

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